Method to stop bleeding at a puncture site of an artery of a patient&#39;s wrist

ABSTRACT

A method to stop bleeding at a puncture site of an artery on a wrist of a patient comprises wrapping a flexible band of a hemostatic device around the wrist of the patient, wherein the hemostatic device also includes a curved plate, a balloon and a marker used to position the balloon at the puncture site, and wherein the flexible band, the curved plate and the balloon are substantially transparent. The wrapping of the flexible band around the wrist of the patient involves wrapping the flexible band around the wrist of the patient while the balloon is in an uninflated state. The wrapping can also take place while an introducer sheath is in place at the puncture site. The method also involves using the marker to position balloon relative to the puncture site such that the balloon overlies the puncture site, introducing a fluid into the balloon and inflating the balloon, and maintaining inflation of the balloon and compression against the puncture site.

This application is a continuation of U.S. application Ser. No.12/356,969 filed on Jan. 21, 2009 which is a divisional of U.S.application Ser. No. 10/618,964 filed on Jul. 15, 2003, the entirecontent of which is incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a hemostatic device, and moreparticularly to a hemostatic device which is attached to a patient'slimb at a site on the limb where bleeding is to be stopped and which, bythe inflation of a balloon, applies pressure to the site so as to stopbleeding.

2. Background Art

When a procedure involving the percutaneous insertion of an instrumentsuch as a catheter into a blood vessel is carried out for medicaltreatment, examination or diagnosis, bleeding at the puncture site mustbe stopped following subsequent withdrawal and removal of the catheter.Hemostatic devices which are attached by being wrapped around theportion of an arm or leg where the puncture site is located and compressthe puncture site where bleeding is to be stopped are already known inthe prior art (e.g., JP 3031486 U).

In such prior-art hemostatic devices, the pressure applied to the sitewhere bleeding is to be stopped is directed in a substantiallyvertically downward direction, and the hemostatic effect in thispressing direction is inadequate. Therefore, complete hemostatissometimes does not occur or takes a long time to achieve.

Moreover, prior-art hemostatic devices apply pressure not only to thepuncture site where bleeding is to be stopped, but to the surroundingarea as well. Hence, other tissues are also compressed, including otherblood vessels and nerves, sometimes resulting in numbness and poor bloodcirculation.

To keep this from happening, a health care practitioner such as aphysician or nurse must lower the compressive force over time bycarrying out manual operations to reduce the balloon pressure or loosenthe band, which is inefficient and inconvenient.

In addition, when using such prior-art hemostatic devices, the healthcare practitioner visually sights the balloon into place over thepuncture site. It has been pointed out that this makes the balloondifficult to position properly. In fact, due to poor positioning of theballoon, a hematoma may form or blood leakage may occur because of theinability to stop bleeding.

SUMMARY

The method disclosed here provides excellent hemostatic effect. Themethod spontaneously (that is, without manipulation by a health carepractitioner such as a physician or nurse—sometimes referred tohereinafter as the “operator”) eases over time the pressure applied bythe balloon, thus helping to prevent harmful effects from the continuedapplication of pressure, such as numbness, pain and vascular blockage.The method also enables a balloon for compressing a puncture site (asite where blood flow is to be stopped) to be easily positioned at thesite, and thus minimizes blood leakage and hematoma formation due topoor positioning of the balloon.

According to one aspect, a method to stop bleeding at a puncture site ofan artery on a wrist of a patient comprises: wrapping a flexible band ofa hemostatic device around the wrist of the patient, wherein thehemostatic device also comprises a curved plate, a balloon and a markerused to position the balloon at the puncture site, and wherein theflexible band, the curved plate and the balloon are substantiallytransparent. The wrapping of the flexible band around the wrist of thepatient comprises wrapping the flexible band around the wrist of thepatient while the balloon is in an uninflated state and while anintroducer sheath is in place at the puncture site. The methodadditionally involves using the marker to position balloon relative tothe puncture site such that the balloon overlies the puncture site,introducing a fluid into the balloon and inflating the balloon, andmaintaining inflation of the balloon and compression against thepuncture site.

Another aspect of the disclosure here involves a method to stop bleedingat a puncture site of an artery on a wrist of a patient comprises:wrapping a flexible band of a hemostatic device around the wrist of thepatient so that the flexible band encircles the wrist of the patient,wherein the hemostatic device also comprises a plate made of a materialmore rigid than the flexible band and having a curved portion, a balloonand a visually identifiable marker used to position the balloon at thepuncture site, and wherein the flexible band, the plate and the balloonare substantially transparent so that when the flexible band is wrappedaround the wrist of the patient, the puncture site is visible throughthe plate, through the balloon and through the flexible band, and themarker is visible to position the balloon at the puncture site. Themethod also comprises positioning the balloon relative to the puncturesite through use of the marker to so that the balloon overlies thepuncture site and is situated between the plate and the wrist of thepatient, introducing fluid into the balloon after the wrapping of theflexible band around the wrist of the patient to inflate the balloon sothat the balloon applies a compressive force to the puncture site, andmaintaining inflation of the balloon and compression against thepuncture site to stop the bleeding from the puncture site.

These and other aspects of the method will become more apparent uponconsideration of the following detailed description and the accompanyingdrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a bottom view of a first embodiment of the hemostatic deviceaccording to the invention. This shows the side of the device thatserves as the inside surface when the device is attached to the wrist ofa patient.

FIG. 2 is a sectional view showing the same hemostatic device as in FIG.1 during use.

FIG. 3 is a sectional view showing a second embodiment of the hemostaticdevice according to the invention.

FIG. 4 is a sectional view showing a third embodiment of the hemostaticdevice according to the invention.

FIG. 5 is a bottom view of a fourth embodiment of the hemostatic deviceaccording to the invention. This shows the side of the device thatserves as the inside surface when the device is attached to the wrist ofa patient.

FIG. 6 is a sectional view showing the same hemostatic device as in FIG.5 during use.

FIG. 7 is a graph of the change over time in balloon internal pressurein the examples of the invention and the comparative examples which aredescribed later in this specification.

FIG. 8 is a schematic illustration of one aspect of a method to stopbleeding at a puncture site.

DETAILED DESCRIPTION OF THE INVENTION First Embodiment

As noted above, FIG. 1 is a bottom view of a first embodiment of thehemostatic device according to the invention. This shows the side of thedevice that serves as the inside surface when the device is attached tothe wrist of a patient. FIG. 2 is a sectional view showing the samehemostatic device attached and in use on the wrist.

The hemostatic device 1 shown in FIGS. 1 and 2 is used to stop bleedingat a puncture site 510 following the removal of an instrument such as acatheter which was inserted percutaneously into an artery through apuncture formed somewhere on a limb, such as at a wrist 500, for amedical purpose such as treatment, examination or diagnosis. Thishemostatic device 1 has a band 2 which is adapted to be wrapped aroundthe wrist 500, a surface fastener 3 for securing the band 2 in a wrappedstate to the wrist 500, a curved plate 4, a main balloon 5 and asecondary balloon 6.

The band 2 is a flexible belt-like member. As shown in FIG. 2, the band2 is attached to the wrist 500 by being wrapped one full turn around theoutside of the wrist 500 and having portions of the band 2 near bothends thereof mutually overlap. The overlapping portions of the band 2are then secured, or joined, by means of the subsequently describedsurface fastener 3.

The material making up the band 2 is not subject to any particularlimitation, as far as the puncture site 510 can be seen therethrough.Illustrative examples include polyvinyl chloride, polyolefins such aspolyethylene, polypropylene, polybutadiene and ethylene-vinyl acetatecopolymers (EVA), polyesters such as polyethylene terephthalate (PET)and polybutylene terephthalate (PBT), polyvinylidene chloride,silicones, polyurethanes various thermoplastic elastomers such aspolyamide elastomers, polyurethane elastomers and polyester elastomers,and any combinations of the above in the form of, for example, resinblends, polymer alloys or laminates.

It is preferable for the band 2 to be substantially transparent toensure that the puncture site 510 is visible therethrough.

The material making up the band 2 is in the form of a sheet which may beof any suitable thickness. For the band 2 to have a tensile modulus andan elongation percentage within the subsequently described ranges, it ispreferable for the sheet-like material of which it is made to have athickness of about 0.1 to 0.5 mm, and especially about 0.2 to 0.3 mm.

The band 2 may have near the center thereof a curved plate holder 21 forholding the subsequently described curved plate 4. In the embodimentshown in FIG. 1, the curved plate holder 21 is composed in part of aseparate strip-like member joined to the outside (or inside) surface ofthe band 2 by a suitable method such as welding (e.g., heat welding,high-frequency welding, ultrasonic welding) or adhesion (such as with anadhesive or solvent) so as to form a double layer construction. Thecurved plate 4 is inserted into a gap in the double layer and therebyheld.

The band 2 has attached to it, on the inside surface (the front side inthe plane of FIG. 1) thereof near the left end in FIG. 1, the male side(or female side) 31 of a surface fastener 3 such as a velcro-type hookand loop fastener (e.g., the product commonly known in Japan as MagicTape®). Similarly, the band 2 has attached to it, on the outside surface(the back side in the plane of FIG. 1) near the right end in FIG. 1, thefemale side (or male side) 32 of a surface fastener 3. As shown in FIG.2, the band 2 is attached to the wrist 500 by joining together the maleside 31 and the female side 32 of this surface fastener 3. The meansthat may be employed to secure the band 2 in a wrapped state to thewrist 500 are not limited only to surface fasteners 3. Other suitablemeans include snaps, buttons, clips, and members such as buckles throughwhich the ends of the band 2 are passed.

The curved plate 4 is inserted into the gap in the double layerconstruction of the curved plate holder 21 on the band 2, and is therebyheld on the band 2.

The curved plate 4 is shaped so that at least a portion thereof iscurved toward an inner peripheral side of the plate 4. This curved plate4 is constructed of a material more rigid than the band 2 and maintainsa substantially fixed shape.

As is apparent from FIG. 1, in this embodiment, the curved plate 4 has ashape that is elongated in the lengthwise direction of the band 2. Asshown in FIG. 2, the curved plate 4 has a center portion 41 in thelengthwise direction thereof which is substantially uncurved and thusshaped as a flat plate. The curved plate 4 also has, on either side ofthis center portion 41, curved portions 42 which curve toward the innerperipheral side of the plate 4 and along the lengthwise direction of theband 2 (circumferential direction of the wrist 500). The curved portions42 have a radius of curvature R2 which is smaller than the radius ofcurvature R1 of the center portion 41 (in the illustrated arrangement,R1 is substantially infinite).

The material making up the curved plate 4 is not subject to anyparticular limitation, as far as the puncture site 510 can be seentherethrough. Examples of materials of which the curved plate 4 may bemade include acrylic resins, polyvinyl chloride (particularly rigidpolyvinyl chloride), polyolefins such as polyethylene, polypropylene andpolybutadiene, polystyrene, poly(4-methyl-1-pentene), polycarbonates,ABS resins, polymethyl methacrylate (PMMA), polyacetals, polyarylates,polyacrylonitriles, polyvinylidene fluorides, ionomers,acrylonitrile-butadiene-styrene copolymers, polyesters such aspolyethylene terephthalate (PET) and polybutylene terephthalate (PBT),butadiene-styrene copolymers, aromatic and aliphatic polyamides, andfluorocarbon resins such as polytetrafluoroethylene.

It is preferable for the curved plate 4 to be substantially transparentto ensure that the puncture site 510 is externally visible.

Alternatively, the curved plate 4 may have no uncurved portion such ascenter portion 41, and may thus be curved over its entire length.

The method of providing the curved plate 4 on the band 2 is not limitedto the illustrated arrangement, and may involve joining the curved plate4 to the inside surface or outside surface of the band 2 by a suitablemethod such as welding or adhesion. The band 2 need not encircle thewrist 500 completely. For example, another acceptable arrangement is onein which the band 2 is connected to both ends of the curved plate 4. Itis thus not essential for a portion of the band 2 to overlap with thecurved plate 4.

The band 2 or curved plate 4 has connected to the inner side thereof aballoon 5 made of a flexible material. The balloon 5 inflates when afluid (a gas such as air, or a liquid) is introduced therein, thusapplying pressure to the puncture site 510 on the wrist 500.

The balloon 5 is positioned near one end of the curved plate 4 in thelengthwise direction thereof. That is, in the arrangement shown in FIG.2, the balloon 5 is in a position that overlaps with substantially theright half of the curved plate 4.

The material making up the balloon 5 is not subject to any particularlimitation provided it is a material that allows the puncture site 510to be seen. For example, a material similar to that making up the band 2may be used. To facilitate joining of the balloon 5 with the band 2 bywelding, and thus make the hemostatic device 1 easier to manufacture, itis preferable for the balloon 5 to be made of a material which is of thesame nature or type as that making up the band 2.

It is desirable for the balloon 5 to be substantially transparent toensure that the puncture site is externally visible.

The material making up the balloon 5 is in the form of a sheet which maybe of any suitable thickness. For the balloon 5 to have a tensilemodulus and an elongation percentage within the subsequently describedranges, it is preferable for the sheet-like material of which it is madeto have a thickness of about 0.1 to 0.5 mm, and especially about 0.2 to0.3 mm.

The balloon 5 may have a construction in which the edges of sheets madeof the above-described material are sealed together by a suitableprocess such as welding or adhesion to form a sort of pouch. In thearrangement shown in FIG. 1, the balloon 5 is substantially square inthe uninflated state.

The balloon 5 is connected to the band 2 by a flexible connector 11. Inthe present embodiment, the balloon 5 is connected to the band 2 by aconnector 11 only on the side of one end of the curved plate 4; that is,only on the right side in FIG. 2. The connector 11 has a relativelyshort length, thereby keeping the balloon 5 tethered in a positiondeviated to one end of the curved plate 4. The connector 11 ispreferably made of the same material as the balloon 5.

In the present embodiment, because only one side of the balloon 5 isconnected to the band 2 by the connector 11, when the hemostatic device1 is attached to the wrist 500 in the state shown in FIG. 2, the balloon5 assumes a somewhat tilted orientation. As a result, the pressing forceF applied to the puncture site 510 acts in an oblique direction.

As shown in FIG. 1, the balloon 5 has connected thereto an inflator 7for introducing a fluid into the balloon 5. The inflator 7 is composedof a flexible tube 71 which is connected at a proximal end thereof tothe balloon 5 and which has a lumen that communicates with the interiorof the balloon 5, a bulb 72 which is provided at the distal end of thetube 71, and a tubular connector 73 which is joined to the bulb 72. Thetube 71 may include a connector or other means (not shown) which isconnected to the balloon 5 side thereof and adapted to allow the tube 71to be detached from the hemostatic device 1 of the present invention.

Inflation of the balloon 5 is carried out by inserting the protrudingtip of a syringe (not shown) into the connector 73 and pushing a plungeron the syringe so as to introduce fluid within the syringe through theinflator 7 into the balloon 5. Once fluid has been injected into theballoon 5 and the protruding tip of the syringe is withdrawn from theconnector 73, a check valve within the connector 73 closes, preventingthe fluid from leaking out and thus maintaining the balloon 5 in aninflated state.

As shown in FIG. 2, a secondary balloon 6 composed of a flexiblematerial may be provided between the curved plate 4 and theabove-described balloon 5 (sometimes referred to hereinafter as the“main balloon” to avoid confusion) in such a way that all or part of thesecondary balloon 6 overlaps with the main balloon 5. This secondaryballoon 6 functions as a pressing member for pressing against the mainballoon 5.

Under the pressure of the fluid with which it is filled, the secondaryballoon 6 applies to the main balloon 5 a pressing force (arrow f inFIG. 2) which is directed toward substantially the center 520 of thewrist 500. Under the influence of this pressing force f from thesecondary balloon 6, the main balloon 5 in turn applies to the puncturesite 510 a compressive force (arrow F in FIG. 2) that acts in an obliqueor inclined direction (toward the center 520 of the wrist 500) ratherthan vertically downward (that is, in a vertical direction with respectto the surface of the wrist 500). This arrangement provides a betterhemostatic effect and is thus able to more reliably stop bleeding thanwhen compression is applied to the puncture site 510 in a verticallydownward direction.

In the arrangement illustrated in FIG. 2 in which the hemostatic device1 is shown wrapped about the wrist 500, the main balloon 5 is not incontact with the curved plate 4 through the band 2. However, a portionof the main balloon 5 may be in contact with the curved plate 4 throughthe band 2.

The material making up the secondary balloon 6 is not subject to anyparticular limitation, as far as the puncture site 510 can be seentherethrough. For example, materials similar to the above-describedmaterials making up the band 2 and the main balloon 5 may be used. It ispreferable for the secondary balloon 6 to be substantially transparentto ensure that the puncture site 510 is externally visible. The materialmaking up the secondary balloon 6 is in the form of a sheet which mayhave a thickness like that of the material making up the main balloon 5.The secondary balloon 6 may also have a construction like that of themain balloon 5.

In the present embodiment of the invention, the secondary balloon 6 hasa smaller width in the lengthwise direction of the band 2 than the mainballoon 5. Hence, the secondary balloon 6 is smaller in size than themain balloon 5 and thus applies pressure locally to the main balloon 5.This enables the direction of the pressing force F applied by the mainballoon 5 to the puncture site 510 to be more reliably inclined.

Moreover, the secondary balloon 6 is positioned near the right end ofthe curved plate 4 in the lengthwise direction thereof, as shown in FIG.2. This enables the pressing force f applied by the secondary balloon 6to the main balloon 5 to be made more reliably directed toward thecenter 520 of the wrist 500. In turn, the direction of the pressingforce F applied by the main balloon 5 to the puncture site 510 can bemore reliably inclined.

In this embodiment, as mentioned above, the curved plate 4 has, on theside on which the main balloon 5 is positioned (the right side in FIG.2), a curved portion 42 with a radius of curvature smaller than that ofthe center portion 41 of the curved plate 4. The secondary balloon 6contacts, through the band 2, the curved portion 42 of the curved plate4 or a portion to the right side thereof in FIG. 2. In this way, thedirection of the force incurred by the secondary balloon 6 from thecurved plate 4, i.e., the normal direction of the curved plate 4 whereit contacts the secondary balloon 6 through the band 2, is inclinedtoward the center 520 of the wrist 500. As a result, the directions ofpressing force f and pressing force F can be more reliably inclined.

In this embodiment, a portion of the main balloon 5 and a portion of thesecondary balloon 6 are joined together by a suitable method such aswelding or adhesion. At the resulting junction, an opening 12 is formedas a means for communicating between the interior of the main balloon 5and the interior of the secondary balloon 6. When a fluid is injectedinto the main balloon 5 in the manner described above, some of theinjected fluid flows through the opening 12 into the secondary balloon6, so that the secondary balloon 6 inflates as the main balloon 5inflates. In this way, both balloons can be inflated in a singleoperation, providing excellent ease of use and efficiency.

In addition to being joined to the main balloon 5 in the vicinity of theopening 12, the secondary balloon 6 may also be joined to the mainballoon 5 at a place near the connector 11 (on the right end in FIG. 2).This enables pressure to be more reliably applied to the main balloon 5and increases the upward pushing force upon the curved plate 4, makingit easier to move the curved plate 4 away from the wrist 500.

In a different arrangement than that shown in FIGS. 1 and 2, inflationof the secondary balloon 6 by the introduction of a fluid may be carriedout separately from inflation of the main balloon 5.

Moreover, the secondary balloon 6 need not be adapted to inflate withthe injection of a fluid at the time of use as in the presentembodiment. Instead, it may be filled with a fluid and inflated to beginwith; that is, prior to the time of use.

In this invention, the pressing member which presses against the mainballoon 5 is not limited to a secondary balloon 6. Other types ofpressing members that may be used for this purpose include pads made ofa spongy substance, an elastomeric material, an assemblage of fiberssuch as cotton, or combinations thereof.

A method of using the above-described hemostatic device 1 of theinvention is described below.

(1) Before attaching the hemostatic device 1 to a patient's limb, themain balloon 5 and the secondary balloon 6 are placed in an uninflatedstate. In cases where the procedure is carried out at the wrist 500, thesite of puncture 510 into an artery is generally on the inner side ofthe wrist 500 (where the tendons are located) and on the thumb side.There will be times where an introducer sheath (not shown) is insertedand in place at the puncture site 510, and other times where no suchsheath is present (schematically illustrated by way of example in FIG.8). The method of using the inventive hemostatic device 1 is the same inboth cases. While compressing the puncture site 510 with a finger orother suitable means, the operator positions the main balloon 5 over thepuncture site 510, wraps the band 2 around the wrist 500, and secures,or joins, the band 2 near both ends thereof with a surface fastener 3.

In a method of using the hemostatic device 110 according to thesubsequently described fourth embodiment of the invention, the operatortypically wraps the band 2 around a wrist 500 where an introducer sheathmay or may not be inserted and in place (schematically illustrated byway of example in FIG. 8), positions the main balloon 5 (band 2) so thata marker 8 provided on the balloon 5 lies over the puncture site 510,and secures, or joins, the band 2 near both ends thereof with a surfacefastener 3.

(2) Once the hemostatic device 1 has been attached to the wrist 500, asyringe (not shown) is connected to the connector 73 on the inflator 7and a fluid is introduced into the main balloon 5 and the secondaryballoon 6 as described above, thereby inflating the main balloon 5 andthe secondary balloon 6. In the present invention, the degree ofinflation by the main balloon 5 and the secondary balloon 6, i.e., thecompressive force applied to the puncture site 510, can easily beadjusted for the particular medical case and circumstances by varyingthe amount of fluid introduced at this time, making operation of thehemostatic device 1 very easy and efficient.(3) Once the main balloon 5 and the secondary balloon 6 have beeninflated, the syringe is separated from the connector 73. If anintroducer sheath is in place at the puncture site 510, it is removed atthis point.

If the connector 73 has a check valve, the check valve is closed afterthe syringe is removed, which will prevent the sudden leakage of fluid.Thus, the main balloon 5 and the secondary balloon 6 remain inflated andso compression against the puncture site 510 is maintained (see FIG. 2).In this state, the main balloon 5 applies pressure locally to thepuncture site 510 and its environs. Moreover, inflation of the mainballoon 5 and the secondary balloon 6 causes the curved plate 4 to moveaway from the surface of the wrist 500 so that it does not readily comeinto contact with the wrist 500. Accordingly, compressive forces areconcentrated at the puncture site 510 and its environs, resulting in anexcellent hemostatic effect while avoiding the compression of othertissues, including blood vessels not requiring hemostatis and nerves,and thus effectively preventing undesirable effects such as numbness ofthe hand and poor circulation.

(4) In the fifth embodiment of the invention described later in thisspecification, after inflation of the main balloon 5 is complete, theinternal pressure of the balloon 5 gradually decreases. The internalpressure 60 minutes after inflation falls to about 20 to 70% of theinitial internal pressure. As a result, the compressive force applied tothe puncture site 510 eases over time, making it possible to prevent theharmful effects of a sustained compressive force, such as numbness,pain, and the occlusion of blood vessels (poor blood circulation).(5) When bleeding is determined to have stopped to a sufficient degree,the hemostatic device 1 of the invention is removed from the puncturesite 510. The length of time from the completion of balloon 5 inflationuntil removal of the hemostatic device 1 (referred to hereinafter as the“hemostatic device attachment time”) is not subject to any particularlimitation. Hemostatis using this device may be carried out for a periodof, for example, 150 to 360 minutes. The hemostatic device attachmenttime may be selected as appropriate for the individual patient and hisor her medical condition.

Second to fifth embodiments of the inventive hemostatic device aredescribed below in conjunction with the attached drawings, withparticular reference to those features which differ from the foregoingfirst embodiment of the invention. Descriptions of like features areomitted.

Second Embodiment

FIG. 3 is a sectional view showing a hemostatic device according to asecond embodiment of the invention during use.

The hemostatic device 10 in this embodiment has the same features as thehemostatic device 1 in the above-described first embodiment, except thatthe secondary balloon 6 is connected to the band 2 via a flexibleconnector 13.

In the present embodiment, the secondary balloon 6, by being connectedto the band 2 via a connector 13 on the same side as the connector 11for the main balloon 5 (i.e., the right side in FIG. 3), more easily andreliably assumes a tilted orientation. This more readily allows thepressing force f applied to the main balloon 5 to act in an obliquedirection (that is, in a direction which causes the main balloon 5 toface substantially the center 520 of the wrist 500), thus enabling abetter hemostatic effect to be achieved.

Third Embodiment

FIG. 4 is a sectional view showing a hemostatic device according to athird embodiment of the invention during use.

The hemostatic device 100 in this embodiment has the same features asthe above-described first embodiment, except that it lacks a secondaryballoon 6.

That is, in the present embodiment, there is no secondary balloon 6.Instead, the main balloon 5 comes into contact with the curved plate 4through the band 2. Moreover, the balloon 5 is connected to the band 2only on one side through a connector 11, thus giving the balloon 5 asomewhat tilted orientation, as shown in FIG. 4. This enables thecompression force F applied to the puncture site 510 to act in anoblique direction (that is, in a direction facing the center 520 of thewrist 500). As in the first embodiment described above, the result isthat a better hemostatic effect can be obtained.

Moreover, as in the first embodiment, the balloon 5 is positioned on theconnector 11 side (the right side in FIG. 4) with respect to the curvedplate 4. The curved plate 4 has a center portion 41 and, on the side onwhich the balloon 5 is positioned (the right side in FIG. 4), a curvedportion 42 with a smaller radius of curvature than the center portion41. On the right side (in FIG. 4) of the curved portion 42, the curvedplate 4 pushes the balloon 5 (through the intervening band 2) in adirection facing the center portion 520 of the wrist 500. Hence, in thisembodiment, the compressive force F acts more reliably in an obliquedirection.

Fourth Embodiment

FIG. 5 is a bottom view of a fourth embodiment of the hemostatic deviceof the invention. This shows the side of the device that serves as theinside surface when the device is attached to the wrist of a patient.FIG. 6 is a sectional view showing the same hemostatic device as in FIG.5 when attached and in use on the wrist of a patient.

As shown in FIG. 5, the hemostatic device 110 of the present embodimenthas a marker 8 provided on the inside surface of the main balloon 5;that is, the surface which comes into contact with the puncture site 510(the front side in the plane of FIG. 5). Providing such a marker 8 onthe balloon 5 in the hemostatic device 110 of this embodimentfacilitates proper positioning of the balloon 5 at the puncture site510, which in turn helps prevent blood leakage and hematoma formationdue to poor positioning of the balloon 5.

As shown in FIG. 5, it is preferable for the marker 8 to be provided atthe center of the balloon 5; that is, to be centered at the intersectionof the diagonals for the square shape of the balloon 5. Because thisenables the center of the balloon 5 to be properly positioned at thepuncture site 510, when the balloon 5 has been inflated, the compressiveforce applied by the balloon 5 acts reliably upon the puncture site 510.

The marker 8 is not limited to any particular shape. Examples ofsuitable shapes include circular, triangular and square shapes. In FIG.5, the marker 8 has a square shape.

No particular limitation is imposed on the size of the marker 8.However, when the marker 8 is square, for example, it is preferable forthe length of one side of the square to be in a range of 1 to 4 mm. Ifthe length of one side is 5 mm or more, the marker 8 becomes largerelative to the size of the puncture site 510, which may make the centerof the balloon 5 difficult to position properly over the puncture site510.

The marker 8 may be made of any suitable material, including oil-basedcoloring materials such as inks, and pigment-containing resins.

The color of the marker 8 is not subject to any particular limitation,insofar as it is a color that enables the balloon 5 to be properlypositioned at the puncture site 510. However, a greenish color ispreferred because this makes the marker 8 readily visible on blood andthe skin, thus enabling the balloon 5 to be more easily positioned atthe puncture site 510.

It is also desirable for the marker 8 to be translucent so as to enablethe puncture site 510 to be visible from outside of the marker 8.

No particular limitation is imposed on the method used to place themarker 8 on the balloon 5. Examples of suitable methods include printingthe marker 8 onto the balloon 5, welding the marker 8 to the balloon 5,and applying an adhesive to one side of the marker 8 and affixing it tothe balloon 5.

It is also possible to place the marker 8 on the outside surface of theballoon 5; that is, on the side opposite the surface of the balloon 5that comes into direct contact with the puncture site 510 (the back sidein the plane of FIG. 5).

Alternatively, instead of being placed on the main balloon 5, the marker8 may be placed on the band 2, on the curved plate 4, or on thesubsequently described secondary balloon 6. In such cases, it isadvantageous for the marker 8 to be placed in such a way that it can bepositioned over the center of the main balloon 5.

In the hemostatic device 110 of the present embodiment, the band 2should be made of a material which allows the puncture site 510 to beseen. Those materials mentioned earlier in connection with the band inthe first embodiment of the hemostatic device are widely used for thematerial of the band 2 in this embodiment. Further, it is preferable forthe band 2 to be substantially transparent so that the puncture site 510can be reliably seen from the outside and the marker 8 can be easily andproperly positioned at the puncture site 510.

In the hemostatic device 110 of this embodiment, the curved plate 4should be made of a material which allows the puncture site 510 to beseen. Those materials mentioned earlier in connection with the curvedplate in the first embodiment of the hemostatic device are widely usedfor the material of the curved plate 4 in this embodiment. Further, itis preferable for the curved plate 4 in the present embodiment to besubstantially transparent so that the puncture site 510 is reliablyvisible from the outside and the marker 8 can be easily and properlypositioned at the puncture site 510.

In the hemostatic device 110 of this embodiment, the main balloon 5should be made of a material which allows the puncture site 510 to beseen. Those materials mentioned earlier in connection with the mainballoon in the first embodiment of the hemostatic device are widely usedfor the material of the main balloon 5 in this embodiment. Further, itis desirable for the main balloon 5 to be substantially transparent sothat the puncture site 510 is reliably visible from the outside and themarker 8 can be easily and properly positioned at the puncture site 510.

In the hemostatic device 110 of this embodiment, the second balloon 6should be made of a material which allows the puncture site 510 to beseen. Those materials mentioned earlier in connection with the secondballoon in the first embodiment of the hemostatic device are widely usedfor the material of the second balloon 6 in this embodiment. Further, itis preferable for the secondary balloon 6 to be substantiallytransparent so that the puncture site 510 is reliably visible from theoutside and the marker 8 can be easily and properly positioned at thepuncture site 510. By adopting an arrangement in which, as shown in FIG.6, the secondary balloon 6 is connected to the band 2 through aconnector 13 on the same side (the right side in FIG. 6) as theconnector 11 for the main balloon 5, the same effect can be achieved asin the second embodiment described earlier.

Fifth Embodiment

In the hemostatic device of the present embodiment, the balloon 5 isconstructed so that, following complete inflation thereof, the internalpressure decreases over time, the internal pressure 60 minutes afterinflation becoming 20 to 70%, and preferably 30 to 60%, of the initialinternal pressure. Here, “initial internal pressure” refers to thepressure within the balloon 5 ten seconds after inflation is complete;that is, after the balloon 5 has been inflated to a degree sufficient toachieve a compressive force suitable to stop bleeding.

By means of such an arrangement, the compressive force applied by theballoon 5 relaxes suitably (neither too much nor too little) with thepassage of time, making it possible to effectively prevent the harmfuleffects of a sustained compressive force, such as numbness, pain andvascular blockage (poor circulation) at the puncture site 510 and areasperipheral thereto. In particular, the decrease in the internal pressureof the balloon 5 occurs spontaneously without requiring some sort ofmanual operation (such as the loosening of a valve to reduce pressure orrelease gas) by a physician, nurse or other health care practitioner.This makes it possible to avoid the trouble and inconvenience associatedwith such operations.

If the internal pressure 60 minutes after balloon inflation exceeds 70%of the initial internal pressure, the compressive force (internalpressure) at the time of inflation of the balloon 5 remains atsubstantially the same level. In such a case, the ability to avoid harmfrom a sustained compressive force is limited.

On the other hand, if the internal pressure 60 minutes after ballooninflation is less than 20% of the initial internal pressure, the percentdecrease in the internal pressure of the balloon 5 is too large. Thecompressive force of the balloon 5 diminishes before sufficienthemostasis has occurred, which may result in blood leakage at thepuncture site 510.

Specific arrangements for lowering the internal pressure of the balloon5 over time in the manner described above are given below.

A. Make the band 2 and/or the balloon 5 of a material which is flexibleand easily deformed (extended).

The band 2 and/or balloon 5 gradually deform under the internal pressureand resilience of the inflated balloon 5 so as to conform to the shapeof the puncture site 510. As a result, the internal pressure of theballoon 5 decreases, easing the compressive force applied to thepuncture site 510. That is, the decrease in the compressive force actingupon the puncture site 510 is controlled by the physical properties(tensile modulus, thickness, elongation percentage, etc.) of thematerials making up the band 2 and/or balloon 5.

Specifically, the band 2 has a tensile modulus of preferably not morethan 10 gf/mm², and most preferably 2 to 9 gf/mm².

The band 2 wrapped around the wrist 500 has an elongation percentage 180minutes after balloon inflation of preferably 1 to 7%, and morepreferably 3 to 6%.

B. Control the gas permeability of the balloon 5. This enables gaswithin the balloon 5 to pass through the sheet material making up theballoon 5 and be slowly released to the exterior. As a result, theinternal pressure of the balloon 5 gradually decreases, easing thecompressive force applied to the puncture site 510.C. Control the gas permeability of the secondary balloon 6 whichcommunicates with the main balloon 5. The gas within the secondaryballoon 6 passes through the sheet material of which the secondaryballoon 6 is made and is gradually released to the exterior. This bringsabout a gradual decline in the internal pressure of both the secondaryballoon 6 and also the main balloon 5 that communicates with it, easingthe compressive force applied to the puncture site 510.D. Control the gas permeability of the tube 71 which communicates withthe balloon 5 and/or the bulb 72. In this way, the gas within theballoon 5 passes through the tube 71 and/or bulb 72 and is slowlyreleased to the exterior, allowing the internal pressure of the balloon5 to gradually decrease and thus easing the compressive force applied tothe puncture site 510.E. Make the gas backflow-preventing effect of the check valve within theconnector 73 incomplete so that a small amount of gas leaks out throughthe check valve. As a result, a small amount of gas within the balloon 5is steadily discharged to the exterior through the check valve withinthe connector 73, gradually lowering the internal pressure of theballoon 5 and easing the compressive force applied to the puncture site510.F. Combinations of any two or more of above arrangements A to E.

Methods A to F above have the advantage of enabling control of theinterior pressure within the balloon 5 (i.e., pressure reduction overtime) to be achieved with a simple arrangement. Method A in particularenables the interior pressure of the balloon 5 to be controlled bysuitable selection of the constituent materials and dimensions of theband 2 and the balloon 5.

In the hemostatic device of the present embodiment, the internalpressure of the balloon 5 gradually decreases shortly after inflationhas been completed. The internal pressure 60 minutes after dilationfalls to about 20 to 70% of the initial internal pressure. This easesthe compressive force applied to the puncture site 510, making itpossible to prevent various harmful effects due to the sustainedapplication of a compressive force, such as numbness, pain and vascularblockage (poor circulation).

Once it is determined that sufficient hemostasis has been achieved, thehemostatic device is removed from the puncture site 510. The time untilremoval of the hemostatic device following complete inflation of theballoon (i.e., the hemostatic device attachment time) is not subject toany particular limitation, although removal is typically carried outafter about 150 to 360 minutes. This hemostatic device attachment timecan be selected as appropriate for the particular patient and his or hercondition.

EXAMPLES

Examples of the invention and comparative examples are given below byway of illustration and not by way of limitation.

Example 1

A main balloon and a secondary balloon were each fabricated from asubstantially transparent polyvinyl chloride sheet having a tensilemodulus of 8 gf/mm² and a thickness of 0.3 mm. In addition, a band wasfabricated from a substantially transparent polyvinyl chloride sheetalso having a tensile modulus of 8 gf/mm² and a thickness of 0.3 mm. Theband had a length of 190 mm and a width of 40 mm. The main balloon,secondary balloon and band were welded together at the necessary placesto form a hemostatic device according to the fifth embodiment of theinvention having the construction shown in FIG. 1. A curved plate madeof substantially transparent polycarbonate resin and curved at both endswas inserted into a curved plate holder on the band.

This hemostatic device was wrapped around the wrist and the balloon wasinflated by injecting air into the balloon through the connector 73 onthe inflator 7 until the balloon internal pressure reached about 150mmHg. Next, the internal pressure of the balloon was measured, first 10seconds after full inflation of the balloon (initial internal pressure),then 10, 30, 60, 120 and 180 minutes after full inflation. The resultsof measurement are shown in Table 1 below and FIG. 7.

In addition, 180 minutes after inflation, the hemostatic device wasremoved from the wrist and the length of the band was measured. The bandhad a length of 197 mm, representing an elongation percentage of 3.6%.

TABLE 1 Example 1 Time elapsed after Internal pressure of Pressure as apercentage of balloon inflation balloon (mmHg) initial internal pressure10 seconds 161 100 10 minutes 128 79.5 30 minutes 108 67.0 60 minutes 7949.0 120 minutes  66 40.9 180 minutes  64 39.7

Example 2

A main balloon and a secondary balloon were each fabricated from asubstantially transparent polyvinyl chloride sheet material having atensile modulus of 3 gf/mm² and a thickness of 0.2 mm. In addition, aband was fabricated from a substantially transparent polyvinyl chloridesheet material also having a tensile modulus of 3 gf/mm² and a thicknessof 0.2 mm. The band had a length of 190 mm and a width of 40 mm. Themain balloon, secondary balloon and band were welded together at thenecessary places to form a hemostatic device according to the fifthembodiment of the invention having the construction shown in FIG. 1. Acurved plate made of substantially transparent polycarbonate resin andcurved at both ends was inserted into a curved plate holder on the band.

This hemostatic device was wrapped around the wrist and the balloon wasinflated by injecting air into the balloon through the connector 73 onthe inflator 7 until the balloon internal pressure reached about 150mmHg. Next, the internal pressure of the balloon was measured, first 10seconds after full inflation of the balloon (initial internal pressure),then 10, 30, 60, 120 and 180 minutes after full inflation. The resultsof measurement are shown in Table 2 below and FIG. 7.

In addition, 180 minutes after inflation, the hemostatic device wasremoved from the wrist and the length of the band was measured. The bandhad a length of 201 mm, representing an elongation percentage of 5.8%.

TABLE 2 Example 2 Time elapsed after Internal pressure of Pressure as apercentage of balloon inflation balloon (mmHg) initial internal pressure10 seconds 152 100 10 minutes 133 87.5 30 minutes 110 72.4 60 minutes 8455.2 120 minutes  59 38.8 180 minutes  40 26.3

Comparative Example 1

A main balloon and a secondary balloon were each fabricated from asubstantially transparent polyvinyl chloride sheet material having atensile modulus of 16 gf/mm² and a thickness of 0.3 mm. In addition, aband was fabricated from a substantially transparent polyvinyl chloridesheet material having a tensile modulus of 17 gf/mm² and a thickness of0.5 mm. The band had a length of 190 mm and a width of 40 mm. The mainballoon, secondary balloon and band were welded together at thenecessary places to form a hemostatic device having the constructionshown in FIG. 1. A curved plate made of substantially transparentpolycarbonate resin and curved at both ends was inserted into a curvedplate holder on the band.

This hemostatic device was wrapped around the wrist and the balloon wasinflated by injecting air into the balloon through the connector 73 onthe inflator 7 until the balloon internal pressure reached about 150mmHg. Next, the internal pressure of the balloon was measured, first 10seconds after full inflation of the balloon (initial internal pressure),then 10, 30, 60, 120 and 180 minutes after full inflation. The resultsof measurement are shown in Table 3 below and FIG. 7.

In addition, 180 minutes after inflation, the hemostatic device wasremoved from the wrist and the length of the band was measured. The bandhad a length of 191 mm, representing an elongation percentage of 0.5%.

TABLE 3 Comparative Example 1 Time elapsed after Internal pressure ofPressure as a percentage of balloon inflation balloon (mmHg) initialinternal pressure 10 seconds 155 100 10 minutes 131 84.5 30 minutes 12278.7 60 minutes 113 73.9 120 minutes  108 69.6 180 minutes  106 68.3

Comparative Example 2

A hemostatic device manufactured by Nippon Sherwood Medical IndustriesLtd. under the trade name Radiseal was furnished for use. In thishemostatic device, the band was composed of a polyvinyl chloride sheethaving a thickness of about 0.5 mm and the balloon was composed of apolyvinyl chloride sheet having a thickness of about 0.3 mm. The devicelacked a secondary balloon and was constructed such that, when inflated,the balloon pressed against substantially the center of the wrist.

This hemostatic device was wrapped around the wrist and the balloon wasinflated by introducing air from an inflator until the balloon internalpressure reached about 150 mmHg. Next, the internal pressure of theballoon was measured, first 10 seconds after full inflation of theballoon (initial internal pressure), then 10, 30, 60, 120 and 180minutes after full inflation. The results of measurement are shown inTable 4 below and FIG. 7

TABLE 4 Comparative Example 2 Time elapsed after Internal pressure ofPressure as a percentage of balloon inflation balloon (mmHg) initialinternal pressure 10 seconds 153 100 10 minutes 136 88.8 30 minutes 13084.9 60 minutes 125 81.6 120 minutes  117 76.4 180 minutes  113 73.8

Comparative Example 3

A main balloon and a secondary balloon were each fabricated from asubstantially transparent polyvinyl chloride sheet material having atensile modulus of 16 gf/mm² and a thickness of 0.3 mm. In addition, aband was fabricated from a substantially transparent polyvinyl chloridesheet material having a tensile modulus of 17 gf/mm² and a thickness of0.5 mm. The band had a length of 190 mm and a width of 40 mm. The mainballoon, secondary balloon and band were welded together at thenecessary places. In addition, the sheet material making up thesecondary balloon was pierced in three places with a needle to formsmall holes and thereby increase the gas permeability of the secondaryballoon. This yielded a hemostatic device having the construction shownin FIG. 1. A curved plate made of substantially transparentpolycarbonate resin and curved at both ends was inserted into a curvedplate holder on the band.

This hemostatic device was wrapped around the wrist and the balloon wasinflated by injecting air into the balloon through the connector 73 onthe inflator 7 until the balloon internal pressure reached about 150mmHg. Next, the internal pressure of the balloon was measured, first 10seconds after full inflation of the balloon (initial internal pressure),then 10, 30, 60, 120 and 180 minutes after full inflation. The resultsof measurement are shown in Table 5 below and FIG. 7.

TABLE 5 Comparative Example 3 Time elapsed after Internal pressure ofPressure as a percentage of balloon inflation balloon (mmHg) initialinternal pressure 10 seconds 154 100 10 minutes 107 69.5 30 minutes 5636.4 60 minutes 27 17.5 120 minutes  15 9.7 180 minutes  6 3.9

In both Examples 1 and 2 according to the invention, no numbness, painor poor circulation arose in the wrist or areas peripheral thereto, suchas the palm and fingers, when the hemostatic device was attached or evenlater when the hemostatic device was removed from the wrist 180 minutesafter inflation of the balloon.

By contrast, in Comparative Examples 1 and 2, some numbness of thefingers was sensed when the hemostatic device was attached and when thehemostatic device was removed from the wrist 120 minutes or 180 minutesafter inflation of the balloon.

In Comparative Example 3, a sense of pressure by the balloon at thewrist ceased almost entirely to be felt 30 to 60 minutes after ballooninflation. The hemostatic effects were thus presumably insufficient inthis case.

The illustrated embodiments of the hemostatic device of the inventionhave been described above, although many modifications and variationsmay be made thereto in light of the above teachings. It is therefore tobe understood that the invention may be practiced otherwise than asspecifically described without departing from the scope of the appendedclaims. For example, various parts of the hemostatic device having thespecific configurations shown and described herein may be substitutedwith parts of similar function but having other configurations.Moreover, other suitable components may be added to the hemostaticdevice as described herein.

The hemostatic device of the invention is not limited to use on thewrist alone, and can be employed as a hemostatic device for attachmentand use on any portion of a patient's arm or leg (referred tocollectively in this specification as “limbs”).

As described above and demonstrated in the examples, the hemostaticdevice of the invention provides excellent hemostatic effects andmoreover prevents harmful effects such as numbness and poor circulationin areas peripheral to the site of attachment thereof.

An even better hemostatic effect can be obtained when the balloon is ina position deviated to one end of the curved plate in the lengthwisedirection of the band, and especially when the curved plate has, on theside on which the balloon is positioned, a portion with a smaller radiusof curvature than the center portion of the curved plate.

By providing a marker for positioning the balloon at the site wherebleeding is to be stopped, the balloon can easily be properly positionedand blood leakage or hematoma formation due to incorrect placement ofthe balloon can be prevented.

In embodiments of the inventive hemostatic device in which the internalpressure of the inflated balloon decreases over time, the compressiveforce applied by the balloon relaxes suitably (neither too much nor toolittle) with the passage of time, enabling the effective prevention ofharm from a sustained compressive force, such as numbness, pain orvascular blockage (poor circulation) at the puncture site and areasperipheral thereto.

In such embodiments, the decrease in the internal pressure of theballoon occurs spontaneously without requiring some sort of manualoperation (such as the loosening of a valve to reduce pressure orrelease gas) by a physician, nurse or other health care practitioner.This makes it possible to avoid the trouble and inconvenience associatedwith such operations.

What is claimed is:
 1. A method to stop bleeding at a puncture site ofan artery on a wrist of a patient comprising: wrapping a flexible bandof a hemostatic device around the wrist of the patient, the hemostaticdevice also comprising a curved plate, a balloon and a marker used toposition the balloon at the puncture site, wherein the flexible band,the curved plate and the balloon are substantially transparent; thewrapping of the flexible band around the wrist of the patient comprisingwrapping the flexible band around the wrist of the patient while theballoon is in an uninflated state and while an introducer sheath is inplace at the puncture site; using the marker to position balloonrelative to the puncture site such that the balloon overlies thepuncture site; introducing a fluid into the balloon and inflating theballoon; and maintaining inflation of the balloon and compressionagainst the puncture site.
 2. The method of claim 1, wherein the balloonis a first balloon and the hemostatic device comprises a second balloonpositioned between the curved plate and the first balloon.
 3. The methodof claim 2, wherein the second balloon applies a pressing force to thefirst balloon that is directed toward substantially a center of thewrist.
 4. The method of claim 3, wherein a portion of the first balloonand a portion of the second balloon are joined together, and an openingcommunicates an interior of the first balloon and an interior of thesecond balloon.
 5. The method of claim 4, wherein a terminal end of thefirst balloon and a terminal end of the second balloon are connected tothe flexible band, the first balloon being connected to the flexibleband only at the terminal end of the first balloon, and the secondballoon being connected to the flexible band only at the terminal end ofthe second balloon.
 6. The method of claim 2, wherein the marker islocated on the second balloon.
 7. The method of claim 1, wherein themarker is positioned to identify a center of the balloon, and whereinthe using of the marker to position the balloon relative to the puncturesite comprises positioning the marker so that the marker overlies thepuncture site.
 8. The method of claim 1, wherein the introducer sheathis removed from the puncture site after the inflating of the balloon. 9.The method of claim 1, wherein the flexible band is wrapped around thewrist so that the balloon overlaps a thumb side of the wrist.
 10. Themethod of claim 1, wherein the marker is a greenish color.
 11. A methodto stop bleeding at a puncture site of an artery on a wrist of a patientcomprising: wrapping a flexible band of a hemostatic device around thewrist of the patient so that the flexible band encircles the wrist ofthe patient, the hemostatic device also comprising a plate made of amaterial more rigid than the flexible band and having a curved portion,a balloon and a visually identifiable marker used to position theballoon at the puncture site, the flexible band, the plate and theballoon being substantially transparent so that when the flexible bandis wrapped around the wrist of the patient, the puncture site is visiblethrough the plate, through the balloon and through the flexible band,and the marker is visible to position the balloon at the puncture site;positioning the balloon relative to the puncture site through use of themarker to so that the balloon overlies the puncture site and is situatedbetween the plate and the wrist of the patient; introducing fluid intothe balloon after the wrapping of the flexible band around the wrist ofthe patient to inflate the balloon so that the balloon applies acompressive force to the puncture site; maintaining inflation of theballoon and compression against the puncture site to stop the bleedingfrom the puncture site; and wherein the wrapping of the flexible bandaround the patient's wrist is performed while an introducer sheath ispositioned in the puncture site.
 12. The method of claim 11, wherein theballoon is a first balloon and the hemostatic device comprises a secondballoon, the method comprising inflating the second balloon after thewrapping of the flexible band around the wrist of the patient.
 13. Themethod of claim 12, wherein the second balloon is positioned between theplate and the first balloon.
 14. The method of claim 12, wherein thefirst balloon is in direct contact with the wrist of the patient whenthe first balloon is inflated.
 15. The method of claim 12, wherein thesecond balloon applies a pressing force to the first balloon which isdirected toward substantially a center of the wrist.
 16. The method ofclaim 12, wherein an opening communicates an interior of the firstballoon and an interior of the second balloon so that both the firstballoon and the second balloon are inflated by the introduction of thefluid.
 17. The method of claim 12, wherein a terminal end of the firstballoon and a terminal end of the second balloon are connected to theflexible band, the first balloon being connected to the flexible bandonly at the terminal end of the first balloon, and the second balloonbeing connected to the flexible band only at the terminal end of thesecond balloon.
 18. The method of claim 12, further comprising inflatingthe second balloon after the wrapping of the flexible band around thewrist of the patient.
 19. The method of claim 12, wherein the fluidintroduced into the first balloon to inflate the first balloon is alsointroduced into the second balloon to inflate the second balloon. 20.The method of claim 12, wherein the marker is located on the secondballoon, and the positioning of the balloon relative to the puncturesite through use of the marker comprises positioning the first balloonsuch that the marker on the second balloon overlies the puncture site.21. The method of claim 11, wherein the introducer sheath is removedfrom the puncture site after the inflating of the balloon.
 22. Themethod of claim 11, wherein the marker is positioned to identify acenter of the balloon, and the positioning of the balloon relative tothe puncture site through use of the marker comprises positioning theballoon such that the marker overlies the puncture site.
 23. The methodof claim 11, wherein the balloon is in direct contact with the wrist ofthe patient when the balloon is inflated.
 24. The method of claim 11,wherein the marker is visible through the flexible band and through theplate.
 25. A method to stop bleeding at a puncture site of an artery ona wrist of a patient comprising: wrapping a flexible band of ahemostatic device around the wrist of the patient so that the flexibleband encircles the wrist of the patient, the hemostatic device alsocomprising a plate made of a material more rigid than the flexible bandand having a curved portion, a first balloon, a second balloon, and avisually identifiable marker used to position the first balloon at thepuncture site, the flexible band, the plate and the first and secondballoons being substantially transparent so that when the flexible bandis wrapped around the wrist of the patient, the puncture site is visiblethrough the plate, through the balloons and through the flexible band,and the marker is visible to position the first balloon at the puncturesite; positioning the first balloon relative to the puncture sitethrough use of the marker so that the first balloon overlies thepuncture site and is situated between the plate and the wrist of thepatient; introducing fluid into the first and second balloons after thewrapping of the flexible band around the wrist of the patient to inflatethe first and second balloons so that the first balloon applies acompressive force to the puncture site; maintaining inflation of thefirst balloon and compression against the puncture site to stop thebleeding from the puncture site; and wherein a terminal end of the firstballoon and a terminal end of the second balloon are connected to theflexible band, the first balloon being connected to the flexible bandonly at the terminal end of the first balloon, and the second balloonbeing connected to the flexible band only at the terminal end of thesecond balloon.
 26. A method to stop bleeding at a puncture site of anartery on a wrist of a patient comprising: wrapping a flexible band of ahemostatic device around the wrist of the patient so that the flexibleband encircles the wrist of the patient, the hemostatic device alsocomprising a plate made of a material more rigid than the flexible bandand having a curved portion, a first balloon, a second balloon, and avisually identifiable marker located on the second balloon used toposition the first balloon at the puncture site, the flexible band, theplate and the first and second balloons being substantially transparentso that when the flexible band is wrapped around the wrist of thepatient, the puncture site is visible through the plate, through theballoons and through the flexible band, and the marker is visible toposition the first balloon at the puncture site; positioning the firstballoon relative to the puncture site through use of the marker on thesecond balloon so that the marker and the first balloon overly thepuncture site and the first balloon is situated between the plate andthe wrist of the patient; introducing fluid into the first and secondballoons after the wrapping of the flexible band around the wrist of thepatient to inflate the first and second balloons so that the firstballoon applies a compressive force to the puncture site; andmaintaining inflation of the first balloon and compression against thepuncture site to stop the bleeding from the puncture site.